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COVID-19 Vaccine for Kids Under 15: What Is the Hold Up?

"We don't have data to tell us which vaccine is best for kids and what dosing schedules should be," says Dr G Kang.

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Fit
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With schools reopening across the country, and COVID-19 protocols being eased in many states, the question once again arises, what of the unvaccinated little ones?

Decisions surrounding COVID-19 vaccines for children in India have often come after a good bit of waffling from the authorities. A major reason for this has been a lack of conclusive evidence of its benefit in the younger lot.

On Thursday, Union Health Minister, Mansukh Mandaviya, announced that the government was ready to roll out vaccines for children between the ages of 5 and 15, as soon as they got the go ahead from researchers.

In the same vein, the Public Health Agency of Sweden just last month decided against recommending the COVID vaccine for kids between 5 to 15 years of age saying there wasn't enough evidence to show that the benefits outweighed the risks in kids.

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With parts of the world already considering a fourth booster shot for adults, is it wise to leave kids unvaccinated? Should India prioritise vaccinating young children?

Heres what experts in India have to say.

COVID-19 Vaccines for Kids in India: Timeline

In August 2021, Zydus Cadila's 3 dose vaccine became the first COVID vaccine to be approved in India for use in children between 12 and 18 years of age.

This was quickly followed by Covaxin being approved for the same age group.

On the same day, it was also announced that vaccines for kids over the age of 15 would be rolled out starting 3 January, and that only Covaxin will be offered to this age group.

While the Zydus Cadila vaccine has been approved for use in kids, there have been no official updates on the status of its roll out.

On 21 February, Hyderabad based pharmaceutical company Biological E's COVID-19 vaccine, Corbevax was approved in India for use in children between 12 and 18 years of age.

When the vaccines will be rolled out for this age group will depend on the advisory of experts National Technical Advisory Group on Immunisation (NTAGI).

Why the Delay in Vaccine for Under 15s?

In a press conference last week, Union Health Minister, Mansukh Mandaviya, said that the government was awaiting scientific evidence from experts to take a call on vaccines for kids between 5 and 15.

Mandaviya went on to add that the decision to delay the roll outs have nothing to do with a shortage of vaccines in the country.

"We have enough vaccines, there is no shortage of doses. We will definitely follow the recommendation of the scientific community," he was quoted as saying by PTI.

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Not all experts are convinced of the urgency of rolling out COVID vaccines for this age group.

When the announcement for the roll outs were made, Dr Sanjay K Rai, who is also the principal investigator of Covaxin trials for adults and children at AIIMS, called the decision, 'unscientific'.

Speaking to FIT, Virologist Gagandeep Kang says, "ideally, rather than rushing to vaccinate all children now, we should be doing large clinical trials that compare vaccines and schedules, so that we vaccinate children and learn from the data to develop policy."

"Children are at such low risk of severe disease, we should understand that the benefits of vaccinating children as a substantial proportion of the population are much lower than the benefits of vaccinating adults."
Dr Gagandeep Kang, Virologist

Experts have also been lobbying for greater transparency when it comes to the data that have already been collected-phase 2/3 clinical trials of Covaxin and Zydus Cadila in kids (both of which have not been released to the public domain).

"There is much less data for vaccines in children than there is for adults at the moment," Dr Gautam Menon, Professor of Physics and Biology at Ashoka University, told FIT.

"Given that, caution is advisable and a hasty rollout should not be done," he added.

"We do not have data which tell us which vaccine is best for children and what dosing schedules should be and whether using one vaccine shapes immune response to infection forever."
Dr Gagandeep Kang, Virologist
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Moreover, since the ongoing trials in younger kids were conducted when the dominant variant was delta, there might be a need for revised studies to gauge the vaccine's efficacy against omicron.

In fact, just last week, the US FDA deferred the review of Pfizer'sCOVID vaccine or kids under the age of 5, citing low efficacy of the vaccine against the Omicron variant.

What This Means for Young Kids in India

Dr Menon, like Dr Kang, told FIT that the impact of the vaccines in preventing serious disease and death are higher in adults than in children.

However, he added, "given this, continuing with adult vaccinations, perhaps prioritising families of school-going children, should continue to be our strategy in the immediate future."

Parents are also advised to continue enforcing COVID-19 appropriate protocol, especially when the kids are at school.

Speaking to FIT for a previous article, Dr Vineet Parmar, Director and Head, Pediatric, Fortis Memorial Research Institute, Gurugram, explained, "it isn't enough that kids are made to follow these rules, though. The whole family must follow the given guidelines to avoid COVID."

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Topics:  Vaccine   COVID-19   covid vaccine children 

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